- Statement of Changes in Beneficial Ownership (4)
20 2월 2010 - 10:15AM
Edgar (US Regulatory)
FORM 4
[
X
]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0287
Expires:
February 28, 2011
Estimated average burden
hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public
Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940
|
|
1. Name and Address of Reporting Person
*
Sidow Kevin
|
2. Issuer Name
and
Ticker or Trading Symbol
BIOFORM MEDICAL INC
[
BFRM
]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
|
(Last)
(First)
(Middle)
1875 SOUTH GRANT STREET, SUITE 200
|
3. Date of Earliest Transaction
(MM/DD/YYYY)
2/16/2010
|
(Street)
SAN MATEO, CA 94402
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
|
1.Title of Security
(Instr. 3)
|
2. Trans. Date
|
2A. Deemed Execution Date, if any
|
3. Trans. Code
(Instr. 8)
|
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
|
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
|
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
|
7. Nature of Indirect Beneficial Ownership (Instr. 4)
|
Code
|
V
|
Amount
|
(A) or (D)
|
Price
|
Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
(Instr. 3)
|
2. Conversion or Exercise Price of Derivative Security
|
3. Trans. Date
|
3A. Deemed Execution Date, if any
|
4. Trans. Code
(Instr. 8)
|
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
|
6. Date Exercisable and Expiration Date
|
7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
|
8. Price of Derivative Security
(Instr. 5)
|
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
|
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
|
11. Nature of Indirect Beneficial Ownership (Instr. 4)
|
Code
|
V
|
(A)
|
(D)
|
Date Exercisable
|
Expiration Date
|
Title
|
Amount or Number of Shares
|
Director Stock Option (Right to Buy)
|
$3.61
|
2/16/2010
|
|
D
(1)
(2)
|
|
|
10000
|
(1)
(2)
|
12/10/2019
|
Common Stock
|
10000
|
$0
|
0
|
D
|
|
Director Stock Option (Right to Buy)
|
$3.62
|
2/16/2010
|
|
D
(3)
|
|
|
4543
|
(3)
|
10/1/2019
|
Common Stock
|
4543
|
$0
|
0
|
D
|
|
Director Stock Option (Right to Buy)
|
$2.06
|
2/16/2010
|
|
D
(4)
|
|
|
8053
|
(4)
|
7/1/2019
|
Common Stock
|
8053
|
$0
|
0
|
D
|
|
Director Stock Option (Right to Buy)
|
$1.20
|
2/16/2010
|
|
D
(5)
|
|
|
11313
|
(5)
|
4/1/2019
|
Common Stock
|
11313
|
$0
|
0
|
D
|
|
Director Stock Option (Right to Buy)
|
$1.03
|
2/16/2010
|
|
D
(6)
|
|
|
14729
|
(6)
|
1/2/2019
|
Common Stock
|
14729
|
$0
|
0
|
D
|
|
Director Stock Option (Right to Buy)
|
$1.10
|
2/16/2010
|
|
D
(7)
|
|
|
10000
|
(7)
|
12/12/2018
|
Common Stock
|
10000
|
$0
|
0
|
D
|
|
Director Stock Option (Right to Buy)
|
$7.30
|
2/16/2010
|
|
D
(8)
|
|
|
35000
|
(8)
|
7/25/2017
|
Common Stock
|
35000
|
$0
|
0
|
D
|
|
Explanation of Responses:
|
(
1)
|
Vine Acquisition Corp. (the "Purchaser"), initiated a tender offer pursuant to Purchaser's offer to purchase all of the outstanding shares of BioForm Medical, Inc. (the "Issuer") at a cash purchase price of $5.45 per share, without interest thereon, and less any applicable withholding taxes, subject to the terms described in the Offer to Purchase filed with the Securities and Exchange Commission on January 15 , 2010 (the "Tender Offer") and the Agreement and Plan of Merger, dated as of December 31, 2009, by and among Merz GmbH & Co. KGaA, the Purchaser and the Issuer. (Continued in footnote 2).
|
(
2)
|
The shares underlying these options, which were accelerated and became vested in connection with the closing of the Tender Offer and the fact that the reporting person ceased to be a director of the Issuer, were canceled in exchange for a cash payment of $18,400.00 representing the number of vested shares of Issuer's common stock underlying such options multiplied by $5.45, less the aggregate exercise price of the options.
|
(
3)
|
The shares underlying these options, which were fully vested at the closing of the Tender Offer, were canceled at the closing of the Tender Offer in exchange for a cash payment of $8,313.69, representing the number of shares of Issuer's common stock underlying such options multiplied by $5.45, less the aggregate exercise price of the options.
|
(
4)
|
The shares underlying these options, which were fully vested at the closing of the Tender Offer, were canceled at the closing of the Tender Offer in exchange for a cash payment of $27,299.67, representing the number of shares of Issuer's common stock underlying such options multiplied by $5.45, less the aggregate exercise price of the options.
|
(
5)
|
The shares underlying these options, which were fully vested at the closing of the Tender Offer, were canceled at the closing of the Tender Offer in exchange for a cash payment of $48,080.25, representing the number of shares of Issuer's common stock underlying such options multiplied by $5.45, less the aggregate exercise price of the options.
|
(
6)
|
The shares underlying these options, which were fully vested at the closing of the Tender Offer, were canceled at the closing of the Tender Offer in exchange for a cash payment of $65,102.18, representing the number of shares of Issuer's common stock underlying such options multiplied by $5.45, less the aggregate exercise price of the options.
|
(
7)
|
The shares underlying these options, which were accelerated and became vested in connection with the closing of the Tender Offer and the fact that the reporting person ceased to be a director of the Issuer, were canceled in exchange for a cash payment of $43,500.00 representing the number of vested shares of Issuer's common stock underlying such options multiplied by $5.45, less the aggregate exercise price of the options.
|
(
8)
|
The shares underlying these options, which were fully vested at the closing of the Tender Offer, were canceled at the closing of the Tender Offer for no consideration.
|
Reporting Owners
|
Reporting Owner Name / Address
|
Relationships
|
Director
|
10% Owner
|
Officer
|
Other
|
Sidow Kevin
1875 SOUTH GRANT STREET
SUITE 200
SAN MATEO, CA 94402
|
X
|
|
|
|
Signatures
|
/s/ Kevin Sidow
|
|
2/19/2010
|
**
Signature of Reporting Person
|
Date
|
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
|
*
|
If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
|
**
|
Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
|
Note:
|
File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
|
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
|
Bioform Medical (MM) (NASDAQ:BFRM)
과거 데이터 주식 차트
부터 8월(8) 2024 으로 9월(9) 2024
Bioform Medical (MM) (NASDAQ:BFRM)
과거 데이터 주식 차트
부터 9월(9) 2023 으로 9월(9) 2024
Bioform Medical (MM) (나스닥)의 실시간 뉴스: 최근 기사 0
More News Articles